Impact of Preeclampsia onPlatelet Count and Platelet Indices among Sudanese Pregnant Women in Gezira State

Background: Preeclampsia is considered one of the major health problems is associated with pregnancy and one of the causes of maternal mortality. The pathogenesis of preeclampsia associated with platelets activation. Objectives: The aim of this study was to evaluate the platelets parameters (platelet count and platelet indices) in pregnant women with preeclampsia. Methodology: This is a case-control laboratory-basedstudy carried out in Wad Medani Obstetrics and Gynecology Teaching Hospital, Gezira State, Sudan from January to November 2020. A total of 50 pregnant women with preeclampsia as cases (32.20 ± 3.21 years) and 50 normotensive pregnant women as controls (30.68 ± 2.85 years)participated in this study. Three ml of venous blood samples were collected from all participants in K3 EDTA containers. platelets parameters (platelet count and platelet indices) were determined using Mindray BC 3000 Automated Hematology Analyzer. Data were analyzed usingthe SPSS computer program (version 22). Results: The study results showed that the thrombocytopenia account for 56 %, all cases with low PCT (100%). Furthermore, the means of PLTs count, PCT and PDW in cases were (144.40 ± 31.80 × 109/L, 0.13 ± 0.03 % and 15.80 ± 0.45 fl respectively) versus controls (269.40 ± 72.50 × 109/L, 0.22 ± 0.05 % and 15.50 ± 0.29 fl respectively), giving statistically significant differences (P value = 0.000, 0.003 and 0.022 respectively). The mean of PCT of mild cases was lower than severe cases (P value = 0.004); but there were no significant differences in PLTs count, MPV and PDW (P value = 0.379, 0.283 and 0.075 respectively). Conclusion: The study concluded that platelet count (PLTs count) and plateletcrit (PCT) were significantly decreased in pregnant women with preeclampsia especially, so, platelets parameters especially (PLTs count and PCT) should beincluded for assessing and predictingthe risk of severe preeclampsia.

Comparison of peripheral blood smear examination with automated haematology analyzer for diagnosing different types of anemia.

Objective: This study aims to determine diagnostic accuracy of peripheral blood smear and automated haematology analyzer and to determine frequency of different types of anemia diagnosed by peripheral blood smear and automated hematology analyzer. Study Design: Cross Sectional study. Setting: Department of Pathology, Rawal Institute of Health Sciences, Islamabad. Period: November 2015 to April 2016. Material & Methods: Sample size of 149 suspected anemia patients was calculated using WHO calculator with 95% confidence interval. Research approval was taken from hospital ethical board. Patients were approached through non probability consecutive sampling method. Both peripheral blood smear examination and automated haematology analysis of each sample was performed. Diagnostic accuracy and frequency of anemia types was measured. Data analysis was done with the help of SPSS version 25. Chi-square and fissure exact test and ROC curve analysis was applied and significant (p<0.05) results were reported. Results: Total 149 patients were included in study. There were 42(28.2%) male and 107(71.8%) female. Mean age of patients was 35.1±2.1SD. Peripheral blood smear and automated haematology analyzer showed sensitivity (68% vs 92%), specificity (59% vs 88%), PPV (72% vs 92%), NPV (55% vs 88%) and diagnostic accuracy (64% vs 91) respectively. Most common type of anemia diagnosed with peripheral blood smear was microcytic hypochromic anemia with raised RDW 36.7% followed by normocytic normochromic anemia with raised RDW 13.3% and macrocytic anemia (p=0.001) while in automated haematology analyzer microc ytic hypochromic anemia with raised RDW54.4% followed by normochromic normocytic anemoia with normal RDW 11.1% (p=0.000). Conclusion: Automated haematyology analyzer had high diagnostic accuracy for diagnosis of anemia. Microcytic hypochromic anemia and normocytic normochromic are most common anemias diagnosed by peripheral blood smear and automated hematology analyzer and peripheral blood smear cannot be completely replaced by automated haemolytic analyzer. However, if both methods are used simultaneously, more accurate results can be obtained.

The immature platelet fraction, a predictive tool for early recovery from dengue-related thrombocytopenia: a prospective study

Background There is a paucity of predictive factors for early recovery from thrombocytopenia related to dengue. The immature platelet fraction (IPF%) is reflective of megakaryopoiesis and may correlate with recovery from dengue-related thrombocytopenia. Our objective was to assess the predictive value of IPF% on days 2 and 3 of illness for recovery from dengue-related thrombocytopenia. Methods A prospective study was conducted among patients with dengue admitted to our institution (Nawaloka Hospital PLC) from December 2019 to October 2020. Dengue was diagnosed based on positive non-structural antigen 1 or IgM. IPF% data were extracted from the Sysmex-XN-1000 automated hematology analyzer. Clinical data were obtained from electronic medical records. Statistical analyses were performed using SPSS version 20. Results We included 240 patients. An IPF% on day 2 of illness of &gt;7.15% had a sensitivity of 80.0% and specificity of 70.4% for prediction of platelet recovery (defined as platelet count ≥60×109/L) on day 7 of illness. An IPF% of &gt;7.25% on day 3 of illness had a sensitivity of 88.9% and specificity of 47.1% for predicting platelet recovery &gt;60×109/L on day 8 of illness. The IPF% was significantly lower in patients with severe dengue. Platelet recovery was observed within 48 h after the peak IPF% was reached, regardless of severity. Conclusion We propose that IPF% values on days 2 and 3 of illness are a promising predictive tool for early recovery from dengue-related thrombocytopenia.

Evaluation of Mean Platelet Volume (MPV) in Pre-Eclamptic and Normotensive Women in 3rd Trimester of Gestation

Objective: To determine the mean platelet volume (MPV) in pre-eclamptic and normotensive women presenting in 3rd trimester of pregnancy. Study Design: Descriptive Cross-sectional study. Place and Duration: Department of Obstetrics & Gynecology, Multan Medical and Dental College/Ibn-e-Sina Hospital, Multan during from 29-May-2019 to 28-Nov-2019. Methodology: 246 pregnant females were included in this study. Patients were assessed for pre-eclampsia those who were history of blood pressure >140 mmHg and 90 mmHg diastolic as seen on examination on three consecutive readings. Data of maternal hemogram taken at presentation was recording using an automated hematology analyzer. mean platelet volume (MPV) was recorded at completion of 36th week of gestation. Results: Mean age of patients included in this study was 34.22±5.02 years. Mean body mass index (BMI) of patients was 24.58±4.65 kg/m2. Mean parity was 2.63±0.78. Mean blood pressure of patients was 128.37±15.06 mmHg. The mean platelet volume in patients with normotensive pregnancy was 9.27±1.31 fL versus 12.49±1.51 fL in patients pre-eclampsia. This difference was statistically significant with p-value of <0.0001. Conclusion: As a biomarker for preeclampsia severity, MPV is a valuable tool. In a clinical context, MPV is regularly acquired during a complete blood count, making it a potentially cost-effective prediction tool for evaluating pre-eclampsia Keywords: Pregnancy, Pre-eclampsia, Mean Platelet Volume (MPV)

Immature Platelet Fraction: Its Clinical Utility in Thrombocytopenia Patients

Objectives Etiology of thrombocytopenia is multifactorial and its pathogenesis should be distinguished for appropriate management. Newly formed immature platelets are called reticulated platelets (RPs) and can be estimated in peripheral blood using automated hematology analyzers, which express them as immature platelet fraction (IPF). In the present study we intend to assess and establish the clinical utility of IPF in differentiating the two major causes of thrombocytopenia—decreased production and increased destruction of platelets—along with determining its significance in monitoring patients with thrombocytopenia. Materials and Methods Sixty-one cases of thrombocytopenia and 101 healthy controls with normal platelet count were included in the study. IPF and all the other usual blood cell parameters were measured using a fully automated hematology analyzer. Based on the pathogenesis of thrombocytopenia, the cases were divided into groups and the difference in IPF value between the groups was evaluated. Results The reference range of IPF among healthy controls was estimated to be 0.7 to 5.7%. The mean IPF was significantly higher in patients with increased peripheral destruction of platelets (13.4%) as compared to patients with decreased production of platelets (4.6%). The optimal cutoff value of IPF for differentiating patients with increased peripheral destruction of platelets from patients with decreased production of platelets was 5.95% with a sensitivity of 88% and specificity of 75.9%. Conclusion Measurement of IPF is useful for detecting evidence of increased platelet production and helps in the initial evaluation of thrombocytopenia patients. It is a novel diagnostic method which can be used to differentiate patients with thrombocytopenia due to increased destruction of platelets from patients with thrombocytopenia due to bone marrow failure/suppression.

Platelet Parameters Assessment among Sudanese Pregnant Women with Preeclampsia Attending Wad Medani Obstetrics and Gynecology Teaching Hospital

Background: Preeclampsia is considered one of the major health problems associated with pregnancy and one of the causes of maternal mortality. The pathogenesis of preeclampsia associated with platelet activation.Methods: This is a case-control laboratory-based study carried out in Wad Medani Obstetrics and Gynecology Teaching Hospital, Gezira State, Sudan from January to November 2020. The study aimed to evaluate the platelet parameters (platelet count and platelet indices) in pregnant women with preeclampsia. A total of 50 pregnant women with preeclampsia as cases (32.20 ± 3.21 years) and 50 normotensive pregnant women as controls (30.68 ± 2.85 years) participated in this study. Three ml of venous blood samples were collected from all participants in K3 EDTA containers. platelet parameters (platelet count and platelet indices) were determined using Mindray BC 3000 Automated Hematology Analyzer. Data were analyzed using the SPSS computer program (version 22). Results: The study results showed that the thrombocytopenia account for 56 %, all cases with low PCT (100%). Furthermore the means of PLTs count, PCT and PDW in cases were (144.40 ± 31.80 × 109/L, 0.13 ± 0.03 % and 15.80 ± 0.45 fl respectively) versus controls (269.40 ± 72.50 × 109/L, 0.22 ± 0.05 % and 15.50 ± 0.29 fl respectively), giving statistically significant differences (P value = 0.000, 0.003 and 0.022 respectively). The mean of PCT of mild cases was lower than severe cases (P value = 0.004); but there were no significant differences in PLTs count, MPV and PDW (P value = 0.379, 0.283 and 0.075 respectively).Conclusion: The study concluded that platelet count (PLTs count) and plateletcrit (PCT) were significantly decreased in pregnant women with preeclampsia especially; so platelet parameters especially (PLTs count and PCT) should be included for assessing and predicting the risk of severe preeclampsia.